The Centers for Disease Control and Prevention (CDC) are warning the public about a multistate Salmonella Kiambu outbreak linked to yellow Maradol papayas. The CDC is also working with the U.S. Food and Drug Administration (FDA) to assess the damage of the epidemic that has resulted in the infection of 47 people in 12 states.

The CDC has received reports of the outbreak in Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Minnesota, New Jersey, Texas, Utah, New York, Pennsylvania, and Virginia. One death was reported in New York.

Yellow Papayas. Image Credit: One Green Planet

The federal health agency performed whole genome sequencing (WGS) on the Salmonella bacteria from the ill people and found that the infected individuals are closely related genetically. The CDC explained that this close genetic relationship indicated that the infected are likely to share a common source of the disease.

CDC and FDA warn people about Salmonella Kiambu outbreak linked to papayas

According to the CDC, reports surfaced since May 17 through June 28. The affected people range in age from less than 1 year to 95, and 67 percent are female. The CDC added that 31 people affected are of Hispanic ethnicity. Out of the 47 cases reported as of July 21, 12 had to be hospitalized. Infections reported after June 23 may not be reported yet because the disease takes an average of 2 to 4 weeks to develop, said the CDC.

The CDC says most people infected with the bacteria develop diarrhea, fever, and abdominal cramps between 12 to 72 hours after infection. In most cases, the disease only lasts 4 to 7 days, and most people recover without treatment. However, several cases can become severe and require hospitalization.

In this latest outbreak, the Kiambu strain of the disease appears to be tougher than others, as the disease takes longer to develop. When diarrhea is too severe in people infected with Salmonella, the infection can spread from the intestines to the blood stream, and in such cases, the illness can cause death unless the individual is treated immediately with antibiotics.

The CDC noted that epidemiologic and laboratory evidence collected indicates that yellow Maradol papayas are the likely the source of the Salmonella outbreak. CDC officials interviewed the infected people and found that 11 of 25 people (44 percent) reported eating papayas before their illness.

They were able to identify the fruit as the source of the outbreak due to an illness cluster identified in Maryland. The CDC describes an illness cluster as two or more people who don’t live in the same house who report eating at the same restaurant, going to a joint event, or buying the fruit at the same grocery store the week before becoming infected.

Caribena Papayas. Image Credit: CBS Maryland

In Maryland, where five people are sick with Salmonella, several others reported eating yellow Maradol papayas purchased from the same grocery store, said the CDC. Lab tests showed Salmonella Kiambu and Salmonella Thompson were found in samples collected from the ill people.

The Maryland Department of Health urged people not to consume Caribeña’s yellow, Maradol papayas.

“The department’s Laboratories Administration tested five yellow Maradol papayas, recently collected at a Baltimore retail location, as part of an ongoing Salmonella case investigation,” said the Maryland Department of Health in its statement. “Three of the five yellow papayas tested were confirmed to be contaminated with Salmonella.”

The department of health noted that the source of the contamination hadn’t been identified, as it could have occurred at any point in the supply chain.

Papayas linked to 2011 Salmonella outbreak

After conducting tests on the papayas, the CDC found the Salmonella Kiambu papaya isolates are closely related to the Salmonella Kiambu isolates from the infected people. The agency is conducting more tests to inform the public about the actual source and cause of this multi-state Salmonella outbreak. However, the agency is warning people not to consume the cited fruit until further notice.

“Based on the available evidence, CDC recommends that consumers not eat, restaurants not serve, and retailers not sell yellow Maradol papayas until we learn more,” said the CDC. “CDC and state and local public health partners are continuing laboratory surveillance through PulseNet to identify additional ill people and to interview them.”

Food Poison Journal reports that papayas have caused outbreaks before, as in 2011 a company called Agromod Produce had to recall papayas after an outbreak of Salmonella Agona that blamed on their papayas. On August that year, the FDA had to ban imports of papayas grown in Mexico due to the widespread of the Salmonella outbreak. Over 15 percent of Mexico-grown papayas were contaminated with the bacteria.